Evaluating the quality of life of patients with Cushing’s syndrome in surgical and conservative treatment

G.D. Narimova, Kh.R. Madaminova

Abstract

Research aim — to study the quality of life of patients with Cushing’s syndrome (CS) depending on the disease duration and applied methods of treatment. Materials and methods. The features of quality of life were studied in 60 patients with CS applied for infertility. The average age of patients was 33.9 ± 12.5 years. The duration of disease was from 3 months to 5 years. The spectrum of researches included clinical, biochemical studies, radioimmune hormonal methods of analysis of the blood, ultrasonic densitometry, which were used in all patients. In all patients, we performed magnetic resonance imaging of the pituitary gland and computed tomography of adrenals. An oral glucose tolerance test was used, if necessary. To evaluate the quality of life of patients, the short version of health questionnaire was used (MOS 36-Item Short-Form Health Survey — MOS SF-36). 36 points of questionnaire were grouped in eight scales. Indexes of every scale vary between 0 and 100, where 100 presents the complete health. Results. Before the treatment, women with СS in the subgroup with complications reported the reliable increase of basal values of adrenocorticotropic hormone (ACTH), cortisol, prolactin on the background of hyperandrogenemia and ovarian insufficiency. In patients with СS from the second subgroup (without complications), against the background of significant increase of basal values of cortisol, prolactin, hyperandrogenemia, there was marked unreliable decline of estradiol and progesterone levels. In patients with СS with surgical treatment in the subgroup with complications, 1 month after the surgery the normalization of levels of ACTH and cortisol was marked, and through 6 months this state was saved. In patients with СS with surgical treatment in subgroup 2 (without complications) 1 month after the operation, the normalization of levels of ACTH and cortisol was marked, and through 6 months the state remained former. Conclusions. Six months after the conducted conservative therapy for patients with CS, in 21 (81 %) of them hypercorticoidism was saved, and the parameters of quality of life remained lower than in the group of patients with surgical treatment and healthy people.